Tesamorelin vs Ipamorelin
An FDA-approved GHRH analogue with randomized visceral-fat data versus an investigational ghrelin mimetic.
Research use only. A summary of published literature for educational reference — not medical advice and not a guide to human use.
The short version
Tesamorelin is FDA-approved (Egrifta) for excess abdominal fat in adults with HIV-associated lipodystrophy, backed by randomized trials. Ipamorelin works through the ghrelin receptor and its published phase 2 trial, in postoperative ileus, was negative. They act on different receptors and have never been compared directly.
At a glance
Class
GHRH analogue
Ghrelin-receptor (GHS-R) agonist
Approval status
FDA-approved (Egrifta) for HIV-associated abdominal fat only
Investigational; no approved indication
Headline trial
412-patient RCT: visceral fat −15.2% vs +5.0% at 26 weeks
Phase 2 RCT: no significant benefit for postoperative ileus
Evidence depth
Phase 3 trials plus FDA label
One phase 2 trial plus preclinical pharmacology
Research vial sizes
10 / 20 mg
5 / 10 mg
The details · tap a section to open it
01
How they work
Tesamorelin is a stabilised GHRH analogue that activates pituitary GHRH receptors, raising the body's own GH and, downstream, IGF-I.
01
How they work
Tesamorelin is a stabilised GHRH analogue that activates pituitary GHRH receptors, raising the body's own GH and, downstream, IGF-I.
Tesamorelin is a stabilised GHRH analogue that activates pituitary GHRH receptors, raising the body's own GH and, downstream, IGF-I.
Ipamorelin instead activates the ghrelin receptor, which also releases GH and affects gut motility.
02
What studies measured
In a randomized placebo-controlled trial of 412 people with HIV and abdominal fat accumulation, CT-measured visceral fat changed −15.2% with tesamorelin versus +5.0% with placebo at 26 weeks (P<0.001); IGF-I rose about 81%.
02
What studies measured
In a randomized placebo-controlled trial of 412 people with HIV and abdominal fat accumulation, CT-measured visceral fat changed −15.2% with tesamorelin versus +5.0% with placebo at 26 weeks (P<0.001); IGF-I rose about 81%.
In a randomized placebo-controlled trial of 412 people with HIV and abdominal fat accumulation, CT-measured visceral fat changed −15.2% with tesamorelin versus +5.0% with placebo at 26 weeks (P<0.001); IGF-I rose about 81%.
Ipamorelin's 117-patient phase 2 trial after bowel resection found no significant difference in time to tolerating solid food (25.3 versus 32.6 hours, P=0.15). It did not measure visceral fat.
03
Reported side effects
The tesamorelin label lists elevated IGF-I, glucose intolerance, fluid retention, hypersensitivity and injection-site reactions, and contraindicates use in active cancer, pregnancy and pituitary disruption. More treated participants withdrew for adverse events in the trial.
03
Reported side effects
The tesamorelin label lists elevated IGF-I, glucose intolerance, fluid retention, hypersensitivity and injection-site reactions, and contraindicates use in active cancer, pregnancy and pituitary disruption. More treated participants withdrew for adverse events in the trial.
The tesamorelin label lists elevated IGF-I, glucose intolerance, fluid retention, hypersensitivity and injection-site reactions, and contraindicates use in active cancer, pregnancy and pituitary disruption. More treated participants withdrew for adverse events in the trial.
Ipamorelin's short postoperative trial cannot speak to long-term or metabolic safety.
04
Evidence limits
Tesamorelin's results apply to HIV-associated lipodystrophy and are not evidence for general weight loss. Ipamorelin has no published visceral-fat or body-composition trial in humans.
04
Evidence limits
Tesamorelin's results apply to HIV-associated lipodystrophy and are not evidence for general weight loss. Ipamorelin has no published visceral-fat or body-composition trial in humans.
Tesamorelin's results apply to HIV-associated lipodystrophy and are not evidence for general weight loss. Ipamorelin has no published visceral-fat or body-composition trial in humans.
Citations
Metabolic effects of a growth hormone-releasing factor in patients with HIV
3 papers
Citations
Metabolic effects of a growth hormone-releasing factor in patients with HIV
- [1]Randomized controlled trial2007
Metabolic effects of a growth hormone-releasing factor in patients with HIV
Falutz J, et al. N Engl J Med, 2007.
Read paper ↗ - [2]Phase 2 randomized controlled trial2014
Prospective, randomized, controlled, proof-of-concept study of the Ghrelin mimetic ipamorelin for the management of postoperative ileus in bowel resection patients
Beck DE, et al. Int J Colorectal Dis, 2014.
Read paper ↗ - [3]Regulatory label2025
EGRIFTA (tesamorelin) prescribing information
US Food and Drug Administration FDA label, 2025.
Read paper ↗
Research use only. A summary of published literature for educational reference — not medical advice and not a guide to human use.
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